Of mind, body and community.

Topeka — The leader of the Kansas Hospital Association said Friday that the state needs to take a serious look at expanding Medicaid under the federal Affordable Care Act.

“The bottom line for us is, frankly, we think it presents an opportunity to the state to look at some additional funding for a program that is already under-funded,” said Tom Bell, president of the Kansas Hospital Association.
Gov. Sam Brownback, a conservative Republican, has said he is studying the issue. Several conservative Republican governors have rejected the option out of hand.

Bell said his association is working with Brownback on the issue.

“What we have tried to do, knowing the governor’s caution, which is reasonable, is to try to work with the administration and help answer the questions that the state needs to answer,” Bell said.

Currently, Medicaid provides health care coverage to about 380,000 Kansans, with the largest portion of them — about 230,000 — being children. The rest are mostly lower-income, pregnant women, people with disabilities and the elderly. The $2.8 billion program is funded with federal and state dollars.

Medicaid in Kansas doesn’t cover low-income adults who don’t have children. And a nondisabled adult with children is eligible only if his or her income is below 32 percent of the poverty level, which is approximately $5,000 per year. That is about the most difficult eligibility level in the country.

But starting in 2014, the ACA creates an eligibility level of 138 percent of the federal poverty level, which is $15,415 per year for an individual and $26,344 per year for a family of three.

Estimates indicate that Kansas’ Medicaid enrollment would increase by 135,000 people under the new rules. In addition, many more children probably would be helped, because when parents have access to insurance, it is more likely their children will, too.

If Kansas opts for the expansion, the federal government would pay for 100 percent of the additional cost for three years starting in 2014. Then the federal share would drop to 90 percent by 2020.

Bell said the expansion would help Kansas hospitals and thousands of Kansans who would probably receive better health care instead of waiting to be treated in an emergency room.

But he said he understood how some policymakers would be hesitant, given the federal government’s budget problems.
On the other hand, Bell said, “It makes no sense for a state to jump out and say, ‘I’m not going to do this.’”

On Thursday, Missouri Gov. Jay Nixon, a Democrat, announced that he would push for the Medicaid expansion.

“If we take a pass on billions of health care dollars — dollars that come out of Missourians’ paychecks — that money will go to some other state. They’ll get the benefit, and we’ll get the bill,” Nixon said. “That’s not smart, and that’s not right.”

Republican legislative leaders, however, said Nixon’s proposal was probably dead on arrival.

Comments

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($8,160 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates.

Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 51 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $400 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The links below will lead you to more specific information on the details of single-payer: